HYPERTENSION (High Blood Pressure)

General Information

DEFINITION--Blood is forced through the arteries under systolic pressure; when the heart rests between beats, a diastolic pressure remains. Blood pressure is a measure of these two pressures. Normal pressure is considered 120/80. Blood pressure normally goes up as a result of stress or physical activity, but a person with hypertension has high blood pressure at rest. The diagnosis of hypertension is made when the readings are consistently high. Hypertension is sometimes called "the silent killer" because it often has no early symptoms.

BODY PARTS INVOLVED--Heart; blood vessels; kidneys and eyes (advanced stages).

SEX OR AGE MOST AFFECTED--All ages, but most common in adults.

SIGNS & SYMPTOMS--

Usually no symptoms unless disease is severe. Following are symptoms of a hypertensive crisis:

• Headache; drowsiness; confusion.
• Numbness and tingling in the hands and feet.
• Coughing blood; nosebleeds.
• Severe shortness of breath.

CAUSES--

Usually unknown. A small number of cases result from:

• Chronic kidney disease.
• Severe narrowing of the aorta (major artery of the heart).
• Disorders of some endocrine glands.
• Hardening of the arteries.

RISK INCREASES WITH

• Adults over 60; sedentary lifestyle.
• Obesity; smoking; stress; alcoholism.
• Diet that is high in salt or saturated fat.
• Genetic factors. Hypertension is most common among blacks.
• Family history of hypertension, stroke, heart attack or kidney failure.
• Use of contraceptive pills, steroids and some appetite suppressants or decongestants.

HOW TO PREVENT--Essential hypertension (from unknown causes) cannot be prevented at present. If you have a family history of hypertension, obtain frequent blood-pressure checks. If hypertension is detected early, treatment that includes diet, exercise, stress management and medication can usually prevent complications.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory studies such as blood studies of kidney function, urinalysis and ECG (See Glossary).
• X-rays of the chest and kidneys.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Overall treatment goals will be individualized and may involve weight loss; smoking cessation; exercise program; reduction in alcohol consumption; and lifestyle changes to reduce stress.

POSSIBLE COMPLICATIONS

• Stroke; heart attack; kidney failure.
• Congestive heart failure and pulmonary edema.

PROBABLE OUTCOME--

• With treatment, complications are preventable (except for possible side effects of drugs). Life expectancy is near normal.
• Without treatment, life expectancy is reduced because of likelihood of heart attack or stroke.

How To Treat

GENERAL MEASURES--

• Consider lifestyle changes and practice relaxation techniques to reduce stress (see How to Cope with Stress in Appendix).
• Learn to take your own blood pressure. Your doctor or nurse can teach you.
• See Resources for Additional Information.

MEDICATION--

• Antihypertensive medications can reduce blood pressure if more conservative measures don't work.
• Don't take non-prescription cold and sinus remedies. These contain drugs, such as ephedrine and pseudoephedrine, that raise blood pressure.

ACTIVITY--Normal activity with exercise program at least 3 times a week. This helps reduce stress and maintain normal body weight; it may lower blood pressure. Seek medical advice (your doctor or an exercise physiologist) about an exercise prescription.

DIET--Low-salt diet and reducing diet if overweight (see both in Appendix).

Call Your Doctor If

• You have symptoms of a hypertensive crisis.
• Chest pain occurs. This may be an emergency. Seek help immediately!
• Symptoms of high-blood pressure continue despite treatment.
• New, unexplained symptoms develop.